Crohn's Disease Forum » Support Forum » Mental Health Support » Looking for Advice-Anxiety

03-11-2013, 01:59 PM   #1
gadget71's Avatar
Join Date: Aug 2008
Looking for Advice-Anxiety


I don't post much on here, but when times get tough, we must go where we can get some help! I have been searching and see many others suffer from anxiety, but not sure if any of them suffer in the same way as I and how are they dealing with it.

Let me explain. I am in a high stress job, that occassionally requires professional appearances where I am the center of attention, must present and answer questions.

For many years this was never a problem, I would always get anxious, just like job interviews. And I was not on any anti anxiety or Antidepressants, and did just fine. In about 2005 I started getting anxious more about little things and started on Lexapro. I was on this until this year.

Fast forward to present. In early December I got a request to be at a meeting that came across to me as being a presentation or would require me to give the group information. Then a few days later I got a request to appear at a professional venue I've described above.

I have been highly anxious ever since. Not only when I think about it, but at all times of the day. I have been losing sleep and completely obsessing about it. The first meeting turned out fine, with some medication. The second presentation is not until April. I can't continue to feel this way.

I have tried upping the Lexapro for 4 weeks, then switched to Celexa, for 8 weeks(4 on 20mg, 4 on 40mg). And as of Saturday, went on Zoloft(25mg for 10 days, then 50MG after that).

My first question is: Is is possible with a colon resection where I lost a good amount of my large bowel, that some of the SSRI's are not absorbing properly? I have also heard that much of the serotonin in our bodies comes from our gut? Could that cause an issue with anxiety? Can I not produce enough serotonin on my own because of the loss of bowel?

Last question: I see people taking xanax or other benzos almost daily, while my doc tells me it is the bandage approach and only use as needed. So I try not to take them, but sometimes things get to be too much and I need one. I f I start taking these daily, to get me through the April presentation, will it minimize the impact of the zoloft, and will it be tough to go back to where I was before all this anxiety snowballed. Frankly it has made life a living hell! Being constantly nervous both physically and mentally hurts.

Looking for some advice from those who have travelled this road!
03-11-2013, 02:38 PM   #2
Lisa's Avatar
Join Date: Apr 2010
Location: New York

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Hi Gadget....although I don't suffer from anxiety issues such as you have described, I DO, as part of my job, give presentations on a fairly common schedule, with my audience ranging from office workers to Government Executive staff to attorneys to yes, it can get stressful!

I find the best way for me to de-stress about any given presentation (and I write most of them myself too) is to make sure I know the material, and to be prepared for any quesitons or arguments I may encounter.....such as explaining WHY it is still safer to initially stay in a building when a fire alarm sounds (as long as ther eis no fire in your immediate area) - vs. someone who has dififculty traversing stairs taking them and risking getting injured.....and yes, I do usually get someone who refers back to 9/11.....and the events that unfolded there.....

Anyway - take a deep breath.....put a BIG smile on your face, and when all else fails, BS your way through! That is another thing - if you think you will succeed (at whatever it is) - you are more likely to than if you worry about failing.....

So, what kind of presentations do you have to give? I will share mine!

30 plus years and counting with UC/Crohn's!
on remicade since 11/05

While my experiences may not be what everyone has had- I feel it is worthwhile to share any and all experiences that may be beneficial to others.
03-11-2013, 06:16 PM   #3
Ya noy
Senior Member
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If you have been on Lexapro since 2005, then you've been taking antidepressants for about 7 years. I'm assuming that you discontinued both the Celexa and lexapro since starting on Zoloft, which you supplement with Xanax? If your doctor had no problem prescribing both, why would he call it a "band aide" approach?

Have you discussed your anxiety with a therapist? Or just a medical doctor?
03-11-2013, 07:26 PM   #4
gadget71's Avatar
Join Date: Aug 2008
Ya noy- you have more questions than answers? I was on lexapro until December after upping it to 20mg. I switched right to celexa and it was not effective after 8 weeks. I just started zoloft. My psychiatrist says to use the alprazolam only occasionally. But my symptoms are daily. I hope the zoloft works for the daily symptoms and I can only use alprazalom occasionally down the road, but for now I worry that they will mask the effects of zoloft?
03-11-2013, 11:12 PM   #5
Ya noy
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The reason I ask is because once you start mixing anti-depressants together in various combinations, they can either make you feel better, or worse, and I Didn't think they prescribed various additional meds to mix and match at will, at least, not any longer.

My brother's girlfriend ended up becoming so depressed and suicidal as a direct result of the various combinations of anti-depressants she was improperly prescibed, that her family won a huge lawsuit against the hospital after she committed suicide. My understanding is it was due to the lack of consistency in her meds, which created too many mood swings.

I don't really know though because I've never taken this type of med myself, and wasn't really related to your question anyway.
03-11-2013, 11:53 PM   #6
Join Date: Jul 2012
Location: Ohio
Have you thought about talking to your dr about something like Buspar? It's less of an antidepressant & more of an anti-anxiety. I've never taken it, but heard it can be pretty effective against generalized anxiety disorder. From what I understand about the med, it's a daily pill, unlike an anti-anxiety like Valium or Xanax that are taken at the onset of symptoms, which in your case sound frequent.

I agree you probably don't want to begin taking the Xanax daily, or multiple tines a day unless you have to. It can lead to tolerance, withdrawal, possible addiction...and could actually make your anxiety worse if/when you come off.

The only other thought I have is this: you said you have a high stress job. Do you drink a lot of coffee or take in large amounts of caffeine to meet the demands of the job? Caffeine increases alertness, but taxes the adrenal glands, which are responsible for the body's "fight or flight" response, among other things. After extended periods of your adrenal glands constantly being stimulated into an "on" state, it can cause you to be sort of on edge all the time. I'm not a coffee drinker, but drink soda & take caffeine in pill form when necessary. I find myself having to take breaks every so often to avoid just that situation.
03-12-2013, 06:36 AM   #7
Join Date: Oct 2012

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I was told that removing the large intestine doesn't stop you absorbing anything other than water and salt. I think my surgeon was refering to nutrients (i.e. you still get the calories, vitamins, etc. from food), but I've never heard of a colectomy affecting the absobtion of medications. (I have no idea about the serotonin thing either.)

I would be very careful about taking benzos regularly. A lot of antidepressants are also used to help people sleep, including benzos, and when I was trying to find a treatment for insomnia, the two GPs I spoke to warned me that they wouldn't want me taking that sort of medication. They're addictive and people who take them build up tolerance, meaning that they have to take more and more of the medication to acheive the same benefits. They also have to go through withdrawal symptoms when stopping them. My GPs said they'd only prescribe them to patients who needed them for a short amount of time, as taking them for more than a couple of weeks is sometimes enough to cause a dependency.

If you can keep your use of medications for only the most stressful occasions, and find other ways to manage anxiety in the mean time, you will avoid potentially getting into a worse situation where you could be dependent on a med that's losing its effectiveness - which would probably just cause you more stress!

I'm sorry I don't have any solutions for the anxiety itself. Does your doctor know of any other anti-anxiety medications which aren't addictive and are suitable for long-term use?
03-12-2013, 11:06 AM   #8
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Join Date: Sep 2010
Gadget to answer your question you would probably want to see where the specific medication is getting absorbed. I believe the majority of things get absorbed in your small bowel while the colon typically recovers fluids (along with a few other things). So I don't think that it's likely that a resection would affect your ability to absorb, though other things might like if you have ongoing inflammation in other parts of your GI tract. That's just my limited understanding though.

Regarding your anxiety I know how you feel. I don't take any meds but in the past I had similar symptoms as yourself. I learned a lot by reading about the different stages of anxiety and phobias. It seems to start with anxiety, then it develops to an OCD-like obsession with phobias to follow. Not to scare you or worry you any more but for me knowing the different stages definitely helped me understand what was going on and eventually helped me to reverse it.
Diagnosed with Crohn's September 2009

50mg Imuran - Jun 2010
increased to 150mg Imuran - Jan 2011
5mg/kg Remicade every 8 weeks - Mar 2011
stopped Imuran - Aug 2011
7.5mg/kg Remicade every 8 weeks - Nov 2011
Remicade is still working - Nov 2014
Colonoscopy shows no Crohn's! - Dec 2014

Current meds - 7.5mg/kg Remicade
06-02-2013, 10:26 AM   #9
Garbanzo's Avatar
Join Date: Nov 2012
Location: California
Gadget, I personally do think there is a connection. there are more serotonin receptors in the gut than in the brain! I think inflammation messes with them.

My advice is to first dial in your diet, next BIG thing for anxiety is a HIGH quality magnesium and good b-complex.

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